Journal of Urban Health

, Volume 86, Issue 6, pp 887–901 | Cite as

Estimating Populations of Men Who Have Sex with Men in the Southern United States

  • Spencer LiebEmail author
  • Daniel R. Thompson
  • Shyam Misra
  • Gary J. Gates
  • Wayne A. Duffus
  • Stephen J. Fallon
  • Thomas M. Liberti
  • Evelyn M. Foust
  • Robert M. Malow
  • For the Southern AIDS Coalition MSM Project Team


Population estimates of men who have sex with men (MSM) by state and race/ethnicity are lacking, hampering effective HIV epidemic monitoring and targeting of outreach and prevention efforts. We created three models to estimate the proportion and number of adult males who are MSM in 17 southern states. Model A used state-specific census data stratified by rural/suburban/urban area and national estimates of the percentage MSM in corresponding areas. Model B used a national estimate of the percentage MSM and state-specific household census data. Model C partitioned the statewide estimates by race/ethnicity. Statewide Models A and B estimates of the percentages MSM were strongly correlated (r = 0.74; r-squared = 0.55; p < 0.001) and had similar means (5.82% and 5.88%, respectively) and medians (5.5% and 5.2%, respectively). The estimated percentage MSM in the South was 6.0% (range 3.6–13.2%; median, 5.4%). The combined estimated number of MSM was 2.4 million, including 1,656,500 (69%) whites, 339,400 (14%) blacks, 368,800 (15%) Hispanics, 34,600 (1.4%) Asian/Pacific Islanders, 7,700 (0.3%) American Indians/Alaska Natives, and 11,000 (0.5%) others. The estimates showed considerable variability in state-specific racial/ethnic percentages MSM. MSM population estimates enable better assessment of community vulnerability, HIV/AIDS surveillance, and allocation of resources. Data availability and computational ease of our models suggest other states could similarly estimate their MSM populations.


Men who have sex with men HIV/AIDS Epidemic modeling HIV/AIDS surveillance Epidemic monitoring Epidemic monitoring Census 



The authors gratefully thank Hannah L.F. Cooper, ScD, Joseph Prejean, PhD, Samuel R. Friedman, PhD, William M. Sappenfield, MD, MPH, and Mary Beth Zeni, ScD, for their review and comments on the manuscript.

This research was conducted under the auspices of the Southern AIDS Coalition (SAC). The SAC MSM Project Team comprises all coauthors and the following: Dano W. Beck, MSW (Florida), Joseph Interrante, PhD (Tennessee), Sigga M. Jagne, BSc, MPA (Kentucky), Khalid A. Kheirallah, MSc (Virginia), Leandro A. Mena, MD, MPH (Mississippi), P. Julie Nakayima, MPH (Kentucky), Patrick C. Packer, BS (SAC Executive Director), M. Beth Scalco, LCSW, MPA (Louisiana), Thomas J. Shavor, MBA (Tennessee), Debbie A. Wendell, PhD, MPH (Louisiana), Tiffany West-Ojo, MPH, MSPH (District of Columbia).


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Copyright information

© The New York Academy of Medicine 2009

Authors and Affiliations

  • Spencer Lieb
    • 1
    Email author
  • Daniel R. Thompson
    • 1
  • Shyam Misra
    • 2
  • Gary J. Gates
    • 3
  • Wayne A. Duffus
    • 4
    • 5
  • Stephen J. Fallon
    • 6
  • Thomas M. Liberti
    • 1
  • Evelyn M. Foust
    • 7
  • Robert M. Malow
    • 8
  • For the Southern AIDS Coalition MSM Project Team
  1. 1.Florida Department of HealthBureau of HIV/AIDSTallahasseeUSA
  2. 2.District of Columbia Department of HealthWashingtonUSA
  3. 3.The Williams Institute, UCLA School of LawLos AngelesUSA
  4. 4.University of South Carolina School of MedicineColumbiaUSA
  5. 5.South Carolina Department of Health and Environmental ControlColumbiaUSA
  6. 6.Skills4, Inc.Ft. LauderdaleUSA
  7. 7.North Carolina Department of Health and Human ServicesRaleighUSA
  8. 8.Florida International UniversityMiamiUSA

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